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33/100

✓ Peer-reviewed alzhub usefulness score 33 out of 100. Cognitive tests and assessment

Topic: Risk, prevention and care in population studies

Surprisingly, demographic normalisation worsened rather than improved diagnostic accuracy for detecting MCI with both MoCA and MMSE, reducing their effectiveness as diagnostic tools and confirming our hypothesis. Demographic normalisation significantly reduced diagnostic accuracy, with AUC decrements of 0.007-0.015 (2-tailed p <0.001) in 7 of 8 CN vs MCI conditions, highlighting that disease-related demographic shifts often negate normalisation benefits and lower the diagnostic performance of MoCA and MMSE. Normalisation failed to consistently improve accuracy for detecting early dementia, with significant decreases in 3 of 8 conditions and a mix of significant and non-significant increases in the others, indicating inconsistent effects on test performance. The current findings indicate that normalisation with the commonly used demographic variables (age, sex, and education) has little effect on the accuracy of MoCA & MMSE for identifying MCI and early dementia. Even this little effect often results in a significantly decreased test accuracy, suggesting that demographic normalisation does more harm than good.

Key findings

Surprisingly, demographic normalisation worsened rather than improved diagnostic accuracy for detecting MCI with both MoCA and MMSE, reducing their effectiveness as diagnostic tools and confirming our hypothesis.
Demographic normalisation significantly reduced diagnostic accuracy, with AUC decrements of 0.007-0.015 (2-tailed p <0.001) in 7 of 8 CN vs MCI conditions, highlighting that disease-related demographic shifts often negate normalisation benefits and lower the diagnostic performance of MoCA and MMSE.
Normalisation failed to consistently improve accuracy for detecting early dementia, with significant decreases in 3 of 8 conditions and a mix of significant and non-significant increases in the others, indicating inconsistent effects on test performance.
The current findings indicate that normalisation with the commonly used demographic variables (age, sex, and education) has little effect on the accuracy of MoCA & MMSE for identifying MCI and early dementia.
Even this little effect often results in a significantly decreased test accuracy, suggesting that demographic normalisation does more harm than good.

Why it matters

Adjusting MoCA and MMSE scores for age, sex and education actually made them slightly worse at detecting mild cognitive impairment, and results for early dementia were inconsistent. This concerns how screening tests are scored, not any treatment, cure or prevention of Alzheimer's disease.

Study details

Evidence strengthLow

How this study scored 33/100

Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Alzheimer s & Dementia)
Journal's citation record	2 / 4	Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29)
Study design	0 / 12	No study design recorded — scores zero, not guessed (not stated in the record — scored 0)
Strength of evidence	1 / 5	Rated “low” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	4 / 5	2025 — within 3 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	0 / 7	Cited 0 times (OpenAlex, 2026-10-10)
Citations per year	0 / 5	0.0 citations a year over 3 year(s) since 2025
Impact for its field and year	0 / 6	Cited 0.0× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	0 / 6	No other study in this library cites it
Still being cited	0 / 4	Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author Maurice A. Smith: h-index 29 (OpenAlex, whole career)
Institution's track record	3 / 3	Harvard University: institution h-index 3,235 (OpenAlex)
Multi-centre collaboration	0 / 3	OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete)
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 41433595)
Free to read	2 / 2	Free to read
Total	33 / 100	—

What each of these 20 components measures, and what this score is not →

Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

APA 7th

Venkatachalapathy, K. P., & Smith, M. A. (2025). Does Demographic Normalisation Improve the Accuracy of the MoCA and the MMSE for Detecting Mild Cognitive Impairment and Early Dementia ? Alzheimer s & Dementia. https://doi.org/10.1002/alz70861_108357

Vancouver

Venkatachalapathy KP, Smith MA. Does Demographic Normalisation Improve the Accuracy of the MoCA and the MMSE for Detecting Mild Cognitive Impairment and Early Dementia ? Alzheimer s & Dementia. 2025. doi:10.1002/alz70861_108357. PMID: 41433595.

BibTeX

@article{venkatachalapathy2025-41433595,
  author  = {Venkatachalapathy, Kamlesh Perumal and Smith, Maurice A.},
  title   = {{Does Demographic Normalisation Improve the Accuracy of the MoCA and the MMSE for Detecting Mild Cognitive Impairment and Early Dementia ?}},
  journal = {Alzheimer s \& Dementia},
  year    = {2025},
  doi     = {10.1002/alz70861_108357},
  pmid    = {41433595},
  url     = {https://doi.org/10.1002/alz70861_108357}
}

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